Organization
KAMRAN KHAN, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE A GUAGENTI (BILLER)
(312) 480-5186
Entity
Organization
Contact information
Practice address
1890 SILVER CROSS BLVD STE 450, NEW LENOX, IL 60451-9518
(815) 723-4387
(815) 723-4634
Mailing address
2720 S RIVER RD STE 218, DES PLAINES, IL 60018-4111
(708) 869-8120
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036121940
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121940
—
IL
Enumeration date
07/06/2018
Last updated
07/06/2018
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